You lifted really heavy yesterday, you took your post workout amino acids and fish oil, but you are still really sore.

How do you treat the pain?

One possible answer is that you might toss back some NSAIDs like aspirin, naproxen, or ibuprofen. Unfortunately we are now finding out that NSAIDs might not be the best choice when it comes to dementia or muscle growth.

The term “non-steroidal” is used to distinguish these drugs from steroids, which (among a broad range of other effects) have a similar eicosanoid-depressing, anti-inflammatory action. As analgesics, NSAIDs are unusual in that they are non-narcotic.

NSAIDs are sometimes also referred to as non-steroidal anti-inflammatory agents/analgesics (NSAIAs) or non-steroidal anti-inflammatory medicines (NSAIMs).

The most prominent members of this group of drugs are aspirin, ibuprofen, and naproxen partly because they are available over-the-counter in many areas.

Now the question becomes:

Are NSAIDs good for us?

Ultimately the answer is a resounding NO!

Two Reasons NSAIDs Are Bad For Us

In a recent study in this week’s issue of Neurology, regular NSAID users reportedly have an elevated risk of developing dementia. Now, if you don’t know what dementia is, allow me to explain.

Dementia is a progressive decline in brain function from disease or damage to the body well beyond what is expected from aging. This affliction affects memory, attention, language, and problem solving, with higher mental function suffering first in the process. In the later stages of dementia people may become disoriented in place and in person.

You don’t want to develop dementia.

The Study

Researchers followed 2,736 members of Group Health who were an average age of 75 at the study’s start. Participants were tracked for 12 years to see if they developed dementia, including Alzheimer’s disease. Participants’ pharmacy records were evaluated for use of prescription and over-the-counter pain relievers, and they were questioned about their NSAID use as well.

The Results

Results showed 351 people had a history of heavy NSAID use at the study’s start, while 107 people became heavy users during the follow-up period. Heavy users took at least one NSAID a day for at least 16 months of a two-year period.

During the study, 476 people developed dementia, and heavy NSAID users had a 66% higher risk of developing the condition than those with low or no use.

Researchers say they were surprised at the results because inflammation is thought to play a role in dementia, and because other studies suggested that anti-inflammatory pills lowered the risk of dementia.

Some experts say this may have occurred because previous studies were based around younger, healthier, better educated subjects. This would, of course, bias the results.

I also happen to know that NSAIDs have a negative effect on protein synthesis. Protein synthesis being the primary function that heals and strengthens muscles tissue after exercise.

The Study

The effects on muscle protein synthesis and soreness after high-intensity eccentric resistance exercise were examined for two commonly used over-the-counter (OTC) pain relievers, ibuprofen and acetaminophen.

Twenty four males were assigned to one of the following three groups:

those who received the maximal OTC dose of ibuprofen (1,200 mg/day)

those who received the maximal OTC does of acetaminophen (4,000 mg/day)

those who received a placebo

They received the medicine after 10-14 sets of 10 eccentric repetitions at 120% of concentric one-repetition maximum with the knee extensors.

The Results

After 24 hours, post exercise skeletal muscle fractional synthesis rate (FSR) was increased in the placebo group, and was unchanged in the ibuprofen and acetaminophen groups.

Neither substance had any effect on whole body protein breakdown, as measured by rate of phenylalanine appearance, on serum creatine kinase, or on rating of perceived muscle soreness compared with placebo group.

The results suggest that OTC doses of both ibuprofen and acetaminophen suppress the protein synthesis response in skeletal muscle after eccentric resistance exercise. We can therefore conclude that these two NSAIDS may work through a common mechanism to hamper protein metabolism in skeletal muscle.

Ultimately you do not want to use NSAIDs to combat delayed onset muscle soreness (DOMS). However if you have inflammation as a result of injury or overuse, you may consider using NSAIDs anyway, as they will reduce the inflammation thereby facilitating recovery. In this case we favor healing over muscle gains.

So I guess the verdict is still out on whether NSAIDs have any effect on dementia, but we know for a fact that they inhibit protein synthesis.

Incidentally, fish oil supplements have a great anti-inflammatory effect. I often throw back 4 recoup|90 fish oil capsules after my workouts.

This was a great article! I was excited to come across it because it is aligned with a product I am helping to promote: StayActiv was developed to provide relief and promote recovery as an all natural alternative to NSAIDs for all of the reasons you mentioned above. Also to offer an alternative to the more well-know negative side effects of NSAIDs, such as stomach and kidney damage. Visit our website at http://www.stayactiv.com.

Really? There is a recent study that looked at long term effects of both these drugs on muscle growth over 3 months and both actually increased muscle mass when compared to the placebo group. So I guess the verdict is still out on that too. It’s called research, and it’s what we should do before writing an article. Google acetaminophen and muscle growth to find the study.

Travis:
The study that I found that indicates even a slight muscle gain benefit from NSAIDs was a study involving the elderly. That study would serve better to draw the conclusion that resistance training in the elderly is really effective, and really beneficial for building and maintaining muscle mass. If you can find a real study with real people, please send us the link.

This is a very interesting idea, however I feel that stating that taking any NSAID are bad, it fairly obvious. The fact remains that the beneficial affects are still “side effects” as are the negative effects. Taking and administering drugs is more of a focus on taking the bad with the good, and vice versa.

“…If you can find a real study with real people, please send us the link.”

That study was done at a major human performance lab. in the United States. And those drugs ARE NOT going to inhibit muscle growth in 30 year olds, when they increase muscle growth in 65 year olds.

Steve, are you crazy?

To anyone reading this – in case you want to know what’s really what – I’m 45 yrs. old and have been lifting 6 years. I started 4 grams of acetaminophen and 1.2 grams of ibuprofen 5 months ago. I’m quite certain I’ve put on 3 or 4 pounds muscle since then. Which is a half way decent amount considering I’m a rather small guy (170 lbs.). Two weeks ago, I upped the doses to 6 grams aceta. and 2.4 grams ibuprofen. Now I’m not recommending anyone take that much, especially that much acetaminophen. I realize I’m really maxing out on those drugs dosage wise. SERIOUSLY – most liver transplants in the USA are needed due to acetaminophen overdose!!! From the research I’ve done, it seems that 6 grams/day is THE VERY UPPER LIMIT. I think anyone trying any higher is crazy!!! Unless maybe if you’re a really huge guy – but, for this drug, I do not know what the relationship is between dosage and body weight.

Anyone can put on 3-4 pounds in half a year. Just because you are taking preposterous dosages of acetaminophen and ibuprofen and have gained a couple pounds, means nothing! In no way has any study I have read, prove conclusively to me that those drugs are directly responsible for increasing muscle mass in the elderly or anyone else. You are batshit crazy yourself, for even attempting to take such a high dosage of NSAIDs!

The only studies I have found that try to prove acetaminophen and ibuprofen build muscle mass, use elderly subjects who already benefit immensely from resistance training. These studies are basically making elderly people exercise, recording their positive gains in muscle mass, making them take NSAIDs, and then reporting that the NSAIDs are responsible for the muscle gain. In reality, elderly people respond favorably to resistance training anyway, and it’s not going to matter if they use NSAIDs because they will gain muscle mass NO MATTER WHAT! In fact, elderly people are usually in various states of discomfort and pain due to their age, so the NSAIDs probably allow them to train harder and longer because they feel less age-related wear and tear.

NSAIDs do not facilitate muscle growth and no one reading this should attempt to take several grams of NSAIDs each day to test the theory unless you want to lose various vital organs in the process.

I swear to God some of the people commenting on this post are freakin’ retards.

Also, you said: “That study was done at a major human performance lab.” Fine. SEND A LINK TO THE DAMNED STUDY!

There are some things I should have mentioned last night, and I was going to do so tonight no matter what. The main thing is that I intend to take that stuff for several more months, then never again as long as I live, because both these drugs have liver damage and blood disorders as rare side effects, even at standard dosage, therefore they’re too dangerous to be taking all ones life. BUT, if they work like growth hormone in that once you stop taking them, you retain most of the extra muscle, it might be worth doing them once in your life. If they are like steroids in that you immediately lose all the extra muscle soon after discontinuing them, then there’s still no point in bothering with them, because they’re too risky to use on a permanent basis. I started trying them on myself, because I was HOPEFUL, that they would work as well on me as on the 60 year olds in the study, and maybe better, if I raised the dose to as high as I could get away with, and because I was HOPEFUL the extra muscle could be retained after stopping the drugs.

Now about my personal experience with these two drugs, OBVIOUSLY, my experiment of one person, is not worth much, but it is worth more than nothing at all. You say anyone can put on 3-4 pounds in a half a year. Not true at all. I’ve lifted continuously for 6 years, and I reached my maximum muscle mass years ago. I hadn’t put on even 1 pound in the final 3-4 years, until I started the acetaminophen and ibuprofen. But like I said, an experiment involving one person isn’t worth much. And I also should mention that scientists do not consider the results of ANY experiment to be fact, until the results are repeated. And the experiment we’re alking about still needs to be done again. BUT, on the other hand, you REFUSE TO ADMIT, that the chances of these drugs working as I have said, are very high. Regarding your comment that older people are often in discomfort and pain due to their age, and these drugs help them to lift harder – that is a possibility. I doubt that’s what’s going on though. I’m guessing the PhD’s running the experiment would have noticed if a lot of the subjects were in enough less pain while lifting, to be exercising enough harder than the rest, to be making extra gains. Those are serious scientists. They don’t OFTEN just mess up. And personally, I feel like those drugs do absolutely zero on helping my aches and pains.

Another thing – I’m NOT taking “preposterous” dosages of acetaminophen and ibuprofen. I’m taking a pretty lot, but only a little more than used in the study, and within tolerable limits. And I’m going to do it only one year out of my life.

One more thing: you said “NSAIDs do not facilitate muscle growth and no one reading this should attempt to take several grams of NSAIDs each day to test the theory….” Make up your mind – “NSAIDs do not facilitate muscle growth” OR “no one reading this should attempt to take several grams of NSAIDs each day to test the theory….” So is it a fact they don’t work, or is it a theory that they do work?? Make up your mind. You had the same mindless logic in a couple other places too, but I’m tired of writing now, so I don’t feel like pointing them out.

Oh come on! I just saw your homepage, showing “Arnold’s Abs.” It lookes like you’re acting as if people can get something like that, by just exercising! Yeah right! Arnold was as big a steroid druggie as you can get! I even heard him admit on TV that he did illegal steroids. And for the information of anyone who doesn’t know it, illegal steroids WORK MAGIC on your physique!
I guess drugs are ok when they suit YOU somehow.

And another thing – you should be ashamed of yourself, for using pictures which make it look like a person can get an incredible body just by exercising, when in reality, they have zero chance in the universe of ever achieving anything like that, and to achieve a body like that would require stacking of illegal steroids, which is by far the most dangerous thing a bodybuilder can do. The MAIN reason guys lift weights, is not because they like looking at themselves in the mirror. It’s because they want girls to look at them! And that is a terribly powerful motivation to develop a GREAT body. So when you get a bunch of people like you, showing all these steroided up guys, the young people get the idea that they can get a body something like that. And when they find out it’s an absolute impossibility, they start thinking about doing steroids, because they want to be loved by girls for the way they look. With their heart being set on this, partly because of guys like you helping to get their hearts set on an incredible body by showing all these LIE photographs, they find it very difficult to say no to the steroids. Especially with steroids being as easy to obtain in almost any gym, as jelly beans in the grocery store! We BOTH KNOW that’s how easy it is to get them! You should be ashamed of yourself for leading young people to set absolutely impossible to achieve goals under the circumstances I’ve described. That’s sadistic! And why do you do it – for money!

I told the muscle growth facts about the acetaminophen and ibuprofen, not because I’m trying to push people into starting to take the stuff, but because “the people have a right to know.” I’m not some kind of dictator sitting around deciding what facts people are allowed to know. And after I told what I did, I gave a stern and strong warning about the possible side effects, as I was ethically required to do. Another reason I told all this stuff, was because you pissed me off by saying that 60 year olds are not “real people.” And you also said the study was not a “real study.” It was a real study all right, and one done by super smart scientists.

“You are batshit crazy yourself, for even attempting to take such a high dosage of NSAIDs!”
Oh yeah, well what do you know about the dosage I’m taking? Obviously nothing! Like I said, I’m taking an amount that’s within tolerable limits. I gave a strong warning about taking a dosage ANY higher than I am, because I don’t want to be responsible in any way, for some young person getting hurt. And I know that a lot of kids out there think that if one pill is good, two is better. Well in this case, IT IS NOT NOT NOT BETTER!!! IT WOULD BE DANGEROUS! I CAN NOT STRESS THIS ENOUGH!
And on the subject of safety, how about you stop tricking young people into getting their hearts set on an incredibe body when they have no hope in the universe. They’re very possibly going to start down the road of stacking illegal steroids. And THAT IS by far the most dangerous thing around!

I have only one new thing to say. I just found it out, and I think it’s BY FAR the most important thing there is to say about NSAID’s. Here it is:

Does anyone have a clue what the lethal dose of acetaminophen is???

It’s only 10 to 15 grams. That’s right. It becomes toxic at about 4 grams. And I’m talking about ONLY ONE SINGLE DOSE! ONE DOSE OF 15 GRAMS WILL KILL YOU!!! That’s the way it is with this stuff. I knew it was dangerous to go anything above what I was taking, but I had no idea how it becomes toxic and lethal just a small amount above that. What kind of capitalist pig monsters are running those pharmaceutical companies? The bottle says “Overdose warning: Taking more than the recommended dose may cause liver damage.” It says nothing else. Those fucking psychos should say on the bottle –
IF YOU TAKE 4 to 6 GRAMS YOU WILL! GET LIVER DAMAGE. AND TAKING 10 TO 15 GRAMS WILL PROBABLY KILL YOU.

Any idiot knows you do not sell pills which will damage your liver for sure at 4 to 6 times the “recommended dose” and kill you at 10 to 15 times the recommended dose, unless you TELL THEM THAT!!!!!!!!!!!!!!

Fred: I remember when all this bs was going down with that David Benton character. He never comments on this blog anymore, but that’s probably because he has died of acute liver damage. Thanks for the comment.

See?… Don’t use steroids.. Build it naturally!!! I’ve seen a lot of individuals especially body builders who uses steroids to make their body muscle bigger. Which is definitely wrong, steroids are muscle killers. It’ll not give directly the side effects but it’ll slowly occur in your body… Ouch.. that hurts.

Your comments about NSAID’s and dementia I find quite worrying. I take maximum daily dose at stretches of 10 days at a time for osteoarthritis (have to have a new hip soon). I think I would rather have an increased rate of future arthritis than an increased risk of dementia. I wonder if there is any more recent study on this topic than the research you refer to in this post? Anyone any knowledge on this

Number 1: Weak studies. The make up of study number one only allows for identification of a correlation and not cause. You include no statistics for study number two so it's impossible to know whether it met power OR if the results were even statistically significant. My guess is that 24 people may not have been enough to meet power or to find a statistically significant result. Number 2: simplistic view of NSAIDs. Aspirin has minimal anti-inflammatory effect and acts more on COX1 (associated primarily with TXA2 inhibition and is involved in platelet aggregation) while Naproxen and Ibuprofen act heavily on both COX2 (mainly anti-inflammatory effects, prostaglandin inhibition) as well as COX1. Don't base your NSAID use on this article.

In that case Alan, please draft an article about the positive, non-dangerous and/or health benefit effects of NSAIDs. Cite at least 2 valid resources to support your points, and I will publish it on Project Swole in response to this NSAID post. If you are not willing to back up your claims as such, then you have wasted your time, because few readers have any idea what you are talking about when you reference TXA2 inhibition, COX1, or COX2. I don’t even mention these in my post. Furthermore, study #1 had more than enough participants to be significant. And also, it is well-known in the sports science industry that NSAIDS do not have a positive effect on protein synthesis. It is commonly advised NOT to take NSAIDS before or directly after a workout. Sorry, but until you prove your argument, I still recommend avoiding NSAIDs post-workout unless you are injured or uncommonly sore.